BACKGROUND
Young people aged between 10 and 24 years represent 30% of India’s total population. Over 35% of all reported AIDS cases in the country occur among those in the age group of 15-24 years indicating that young people are not only at high risk of contracting HIV infection but already constitute a significant percentage of people living with HIV/AIDS.
There is growing evidence of early onset of sexual activity among young people in India. Studies in different cities show that almost 10% of young women and 15-30% of young men indulge in premarital sex. Research suggests that young people who become sexually active during adolescence are more likely to have sex with high risk partners or multiple partners. Early sexual debut of Indian women is generally in the context of marriage while young men become sexually active by the age of 16-19 years.
A survey reports that at a national level although 86% of youth were aware of either HIV or AIDS, only two-thirds among them reported that the disease can be prevented by consistent condom use and by having one faithful uninfected sex partner. Only 28% have reported comprehensive correct knowledge of HIV/AIDS. This proportion was relatively higher for 20-24 age group (30%) compared to the 15-19 years age group (27%).
National AIDS Control Organisation (NACO) in India has focused its efforts on youth over the years using multi-pronged approach like mass media; specific life skills / HIV-AIDS education programme in schools, colleges and workplace; and innovative interventions for school drop-outs. Relevant messages on safe sex, sexuality and relationships have been developed and disseminated via posters, booklets, panels, hoardings and printed material. YUVA (Youth Unite for Victory on AIDS) and Red Ribbon Club (RRC) are two such initiatives taken by NACO to provide access to youth.
Till date, Mumbai District AIDS Control Society has formed Red Ribbon Clubs in more than 200 colleges in the city of Mumbai. Being the end of another academic year, an exploratory research was conducted with youth from RRCs with an objective of understanding their experience with the RRC in the current year (2011-2012) and assessing their engagement in the host of MDACS-organized youth events in the city. The activity also aimed to identify HIV/AIDS related knowledge and attitudes of the youth before and after their involvement with the RRC.
A total of 14 participants were interviewed using focus group discussions. Participants were RRC student leaders in their respective colleges and were randomly selected during a RRC annual review meeting held at MDACS. Participants were requested for their consent after which they were asked to join a group discussion in the training hall facilitated by the moderator. All participants were members of the NSS.
KEY THEMES THAT EMERGED FROM THE DISCUSSION
1. Basic motivation of the students for joining RRC
2. Initial experience in the RRC compared to their current experience at the end of the year
3. Students knowledge levels about HIV/AIDS
4. Participation in and experience of the RRC events
5. Impact of RRC in their respective colleges
BASIC MOTIVATION OF THE STUDENTS FOR JOINING RRC
• The majority voted their faculty or an inspiring senior who was their motivation to join the Red Ribbon Club. Participants shared that in most colleges faculty played an important role in convincing them to join the club and conduct the array of HIV/AIDS related awareness activities within their college and the community.
• Most participants shared that apart from their professors and seniors, the array of interesting activities also excited them to be a part of the RRC, especially interactive modes like street plays and community events.
• A few participants also stated that they joined the RRC not out of personal interest but as it was a part of the NSS. However these youth also added that even though they may have looked at the RRC as a social involvement programme at the start, their outlook has changed over the year and they sense a feeling of achievement now.
INITIAL EXPERIENCE IN THE RRC COMPARED TO THEIR CURRENT EXPERIENCE AT THE END OF THE YEAR
• All participants shared that their personal experience with the RRC has been positive right from the start however they did talk about the initial reactions that they received from their peers (other student members/non-members). “We came across a lot of students who weren’t interested in joining the RRC. They looked at it as a purely NSS effort and would often give the RRC a ‘social work’ label. However we have seen these perspectives change over the year. Many students who have joined the RRC with disinterest at the start finished the year with a changed attitude on RRC and HIV/AIDS.”
• Most participants shared that towards the end of the year, each one of the core members (at least) gained tremendously not only in terms of being more knowledgeable about HIV/AIDS, but also with respect to their confidence, public speaking skills and overall personality development.
• Students who would initially shy away from speaking in front of a group were now able to perform fearlessly in front of a crowd and they enjoyed this process.
• Few expressed that they did face difficulties while organizing certain events. Under these circumstances, they also learned how to tackle a difficult situation and solve it.
• A program’s effectiveness becomes evident when it not only achieves its set objectives but is also able to transform its beneficiaries in a way such that the program could become sustainable. These students have not only fulfilled their roles as RRC leaders in their respective colleges but also try to spread this awareness outside their campus.
STUDENTS KNOWLEDGE LEVELS ABOUT HIV/AIDS
• All participants unanimously agreed that students in their colleges had heard about HIV/AIDS prior to the RRC activities. However most of them were only aware of the sexual transmission of the disease. Very few could list all modes of transmission.
• Apart from misconceptions, another element that continues to exist among the students is varying levels of stigma. Participants also shared that if it took them almost a year to completely understand HIV and the trauma of the inflicted, they could not expect students from college to get rid of the innate stigma by just one event or one street play. These changes in attitudes take time.
• Another student said that, “The IYD was an excellent platform for us students to interact with people from the community and spread awareness through interactive channels like street plays and competitions; however we would like to see the impact of our efforts. We would want to conduct a follow-up in these communities, as this knowledge has to be built on.”
• Overall one can infer that RRC has increased the general awareness and knowledge about HIV/AIDS among the youth but in further interventions there has to be a focus on clearing misconceptions and emphasizing on stigma reduction.
PARTICIPATION IN AND EXPERIENCE OF THE RRC EVENTS
• They spoke about events like the blood drive which tested their planning and organizational skills. Most of the students reported a successful blood drive & collected 20-30 bottles of blood at a minimum. One participant said, “Donating blood is viewed as a positive thing to do and is well appreciated by others. Hence most students do not hesitate to come and donate blood. It does not have any negative undertones.”
• All the students reported participating in the IYD events including the college (condom man game) and community (Mandal) events. Most participants felt that the condom man game was an exciting and creative way of getting across the message of protection and prevention from HIV/AIDS. They even added that a few of their professors showed their support by standing next to the condom man cut out and posing for pictures.
• Most participants wanted to share their success stories revolving around the Ganesh Mandal event. The Mandal event had helped increase the confidence of the students, especially the girls who had had no opportunity to step outside their college premises. They had developed tremendous confidence after interacting with the Mandal officials, mobilizing crowds and performing street plays.
• Another participant shared that through the community IYD event, they got to interact with school children from the age group of 5-8th grade. Towards the end of their three day efforts in the community, they manage to educate these young minds about HIV/AIDS.
• All participants shared that for each community event/competition they drew a crowd of 50-100 people. For events like street play, there was usually a big crowd of people from mixed age groups, both male and female.
• One participant spoke about his interesting experience during the community Mandal event. He said that their Mandal was located right outside Kandivali Station hence they had a huge crowd of 300 people gathered round their troupe that was performing the street play. He also added that right next to the Mandal there was a hotel where commercial sex workers and migrants frequented. It was a known spot for soliciting sex especially in the later hours of the day. It was interesting to see that women and men from the hotel also gathered to watch the play and they took along Saadhan cards at the end of the play.
• The IYD finale was also appreciated particularly the quiz as it not only tested the knowledge levels of the participants’ on stage but also spread knowledge among the participants who were hooked to their seats viewing the LCD screens with the questions and trying to guess the answers among their friends. This was a creative and enriching way of learning about HIV/AIDS almost normalizing the disease with this kind of an approach.
IMPACT OF RRC
• RRC students have not only gained correct information about HIV/AIDS; but they also play a key role in counseling their peers in college about various misconceptions related to HIV/AIDS as well as sex and sexuality.
• A number of misconceptions were also cleared. The RRC members were able to help their peers with the knowledge they had acquired during workshops. A common misconception is about using ‘I Pill’. “Ladke condom nahin pehente hain kyunki voh sochte hain ki sex ke baad ladki I pill le sakti hain aur phir kuchh nahin hoga.” This situation is being dealt with the right knowledge provided to both boys and girls.
• Students have multiple queries when it comes to sexuality and these are not resolved at home as discussing sexuality is considered forbidden in most Indian homes whether urban or rural. This is where the RRC members step in. They are able to talk comfortably on the subject of sex, sexuality and HIV/AIDS with their peers, especially armed with the correct knowledge provided to them.
• One participant shared that they have a drop box for HIV/AIDS related queries where students are allowed to drop in their doubts in chits without revealing their identity. These chits are then discussed in group sessions that are conducted once a while. Though a sizeable portion of questions are misconceptions related to HIV/AIDS majority of the doubts are related to sex and sexuality. This implies that youth are engaging or have an intent to explore their sexuality hence need correct information and guidance to prevent them from engaging in high-risk behavior which could also put them at a risk for HIV.
• Interactive channels like street plays and outdoor events were enjoyed by most students and also rated as the most enriching element of the RRC. Participants shared that the street play training giving to them during the peer educators’ workshop was very interesting and effective. It has not only helped them conduct events successfully but also helped many students overcome their fear of speaking in public and made them more confident.
• Most participants felt that the talk/seminar conducted by the positive speaker as organized by MDACS was the most touching and effective element of the RRC. This helped them to understand HIV and those infected even better and helped to reduce stigma and increase acceptance among students.
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